Should you stretch your neck?

I was working in a chiropractic rehab facility, and I clearly remember rehabbing my first neck pain patient.

Even being the over-confident 25-year-old that I was, I had this unique blend of excitement and straight-up fear over working with someone like this.

“Mary” was this amazing lady, probably in her early 50’s, and someone I really bonded with over the ensuing months. I felt horrible for her because she’d been suffering from chronic neck pain for at least a year before she got to us, and no one had been able to resolve it.

I’ve been thinking more and more about her lately, as I think her situation is a great representation of some things that I’ve done well in the past, as well as shed some light on things that I needed to improve upon.

What did I do poorly, you might wonder?

The most obvious one, in my opinion, was stretching her neck.

What did I do well?

I assessed her, wrote a comprehensive training program, and perhaps most pertinent to this post, we worked on her breathing.

Let’s look at both sides of the equation, as well as how you can learn from my past mistakes!

Should you stretch your neck?

Let’s talk a little bit more about Mary.

I remember when I assessed her she had this horrible head-forward posture, and her scalenes and SCM’s were like cable wire.

I’m not kidding – if you can have a striated and jacked NECK, she was a perfect example!

As you can imagine, when I was assessed her cervical range of motion, it was atrocious.

(Keep in mind if you’re a trainer, assessing cervical range of motion is one thing but you shouldn’t be treating neck pain. I was in a different situation at that point in time, and as a trainer or strength coach, it always makes sense to err on the side of caution and refer out.)

The icing on the cake was that she wasn’t just a poor breather.

She was horrible!

Instead of her belly filling with air when she inhaled (diaphragmatic breathing), her belly or waistline actually got smaller (paradoxical breathing).

One of the things I determined in all my sage wisdom was that since her neck was so stiff, that we obviously needed to stretch it. (Please note heavy sarcasm – I was an idiot!)

Makes sense, right?

Keep in mind I’m not one of the “anti-stretching” zealots; I actually static stretch quite a bit myself, and I think it can be very valuable especially when done efficaciously.

But the question becomes, should you stretch necks?

Taking that a step further, why is their neck so freakin’ tight in the first place?

IF we adhere to the joint-by-joint approach, then we know that the lower cervical spine (C3-C7) need stability, and the upper cervical spine (C1 and C2) need mobility.

As a general rule, I don’t think most people need to “stretch” their necks. Furthermore if you play a collision sport (wrestling, football, etc.), I firmly believe the bulk of your training should focus on neck stability and control.

So if we’re not going to stretch their neck, how are we going to restore normal range of motion?

I’m glad you asked!

Fix the Breath, Fix the Neck

Dr. Craig Liebenson first introduced me to the concept of belly or diaphragmatic breathing during a visit to his facility in February of 2003. This was a huge component of my programming while rehabbing patients, and I’m not sure why I ever got away from it.

If you’re into all the breathing articles and books out there, you’ll find that we take somewhere between 20,000 and 21,000 breaths every single day.

If we count those like we would “reps” in the weight room, that’s a lot of practice!

When evaluating Mary, I noticed she had poor breathing patterns. She couldn’t use her belly and diaphragm to breath, which forced her accessory breathing muscles in her neck to take over the bulk of the workload.

I could’ve stretched her as much I wanted and probably not seen a change. There’s no way you’re going to “offset” 21,000 reps of a poor pattern every single-day!

So how did we end up getting her right?

I knew that breathing was an issue, so we incorporated fully belly breathing into almost every exercise she performed, and especially when we stretched her neck.

(The more I think about it, the more I think this is the most powerful component of Yoga {the breath}, versus the actual stretching component. But I digress.)

This allowed her to shut off or tone down those neck muscles, and let them know they didn’t have to do so much work every single time she took a breath. Instead, the appropriate muscles could do the work.

We also did a ton of postural work for the upper back, deep neck flexors, etc. So the program definitely wasn’t just local in nature, but global as well.

So this combination of re-training the breath, strengthening the appropriate muscles, and then shutting off the hypertonic muscles was what got her better.

The whole program – not one or two constituent parts.

If you’ve read this far, keep in mind this post doesn’t have to apply to just necks.

Interestingly, I just came across this article this morning, that cautions against spinal manipulation for neck pain (http://www.bbc.co.uk/news/health-18356045). More applicable to chiro’s but of interest nevertheless, especially as a long time sufferer of neck pain myself (I’ve always felt far too protective to allow a chiropractor to adjust my neck).

In any event, one of the things I have found provides the most relief, particularly in the morning or after sitting at a desk a long time, is the downward dog yoga pose – it doesnt stretch the neck muscles so much but allows them to relax and helps stretch out my back (or back line from an anatomy trains perspective). Regular exercise is important too I find. The small stabilizing adjustments that need to be made when running, for example, help to keep me in better form. I also came across a yogi who said she suffered neck pain for years, and found that regular headstand helped tremendously in overcoming it (I imagine much caution would be needed to ensure proper posture, form and balance so as not to aggravate rather than alleviate the problem, especially at the outset).

Some of the worst aggravators for me (besides too much time at my computer and stress) are a soft bed and/or pillow. That can ruin me for days.

I would agree with Lindsay about down-dog yoga pose, it’s great. Doing it on a daily bases, since it is so good for my lower back too.
I remember when I developed some neck pain several years ago, a physical therapist told me that my main problem is not lack of cervical spine mobility, but very stiff muscles of my back (probably Trapezius muscle http://en.wikipedia.org/wiki/Trapezius_muscle) and a bad posture. He showed me an exercise which became one of my favorite and which I’m religiously doing every morning as a part of joint mobility routine:
– Lean against a wall or a door, make sure the whole spine touches it, no curvature in lumbar area. Legs are slightly apart from a wall / door to maintain balance/pressure.
– Rise your arms by sliding them along the wall / door from the head level to the top (arms shoulders apart or slightly more.)
– Repeat 20 times. You’ll be surprised how hard it is and how good you feel afterwards.